September 28, 2018
Ongoing Opioid Efforts
A week ago today, state health officials announced that Maryland would receive $66 million in federal funding to help combat the scourge of opioid addiction.
And on Tuesday, U.S. lawmakers unveiled a bipartisan bill aimed at fighting the nation's opioid epidemic. The bill contains some promising provisions, including a boost to treatment access for patients in rural areas and the removal of a 1960s rule that prohibits federal Medicaid reimbursement for certain inpatient treatment centers with mental illness patients.
These are welcome developments. When I met last week with Fran Phillips, newly reappointed Deputy Secretary for Public Health Services, she said opioids are Maryland's most pressing public health problem by far. Yet she fears the sense of urgency about this crisis is waning. Let's not forget that in 2017, drug-related deaths in Maryland rose for the seventh straight year and hit an all-time high of 2,282, with the majority linked to opioids.
Maryland's hospitals know intimately the impact of this crisis. Recent data show that Maryland's rate of opioid related emergency department visits is 70 percent higher than the national average.
Hospitals are acting. From 2014 to 2018, hospitals administered more than 900,000 enhanced screenings to identify potential substance use disorders. This resulted in nearly 155,000 positive screens, 65,000 interventions, and 13,500 referrals to treatment.
In addition, 100 percent of Maryland's hospitals have committed to expanding access to naloxone, a life-saving intervention that helps remove the stigma associated with overdose.
Of course, hospitals are only part of the solution. The Governor's Opioid Operational Command Center is at the heart of a comprehensive, statewide response that includes other stakeholders, especially those in public safety roles. It's truly beneficial to coordinate these efforts from a central hub.
Despite this good work, it's essential that everyone understand that when a substance use disorder patient arrives in the emergency department, the system has already failed on many other levels.
That's why hospitals are eager to work with community partners, both on prevention and to see to it that those in need receive ongoing care and supports to overcome chronic illnesses like addiction.
Your MHA has supported the hospital field throughout this battle and we will continue to do so. Please do not hesitate to suggest ways in which we can be most helpful.

Bob Atlas
President and CEO

MHA Hosts Webinar on Behavioral Health Capacity Study
MHA will host a webinar Monday at 2 p.m. for hospitals participating in the Behavioral Health Capacity Study to discuss next steps. The study is aimed at identifying the cause of discharge delays for behavioral health patients in inpatient units. Since data collection began August 8, at least 175 patients have experienced a delay in discharge of a day or more. Almost 90 percent of those patients were admitted from an emergency department. To register for Monday's webinar, click here .
MHA Hosts 3M Webinar
MHA will host a webinar October 11 at 2 p.m. to p review version 36 of 3M's potentially preventable complications (PPC) grouper, which will be used for payment policy purposes beginning in January. Leaders at 3M will review key updates, which will include those prompted by hospitals during the spring meeting, as well as field questions. Given that version 36 has been finalized, 3M will not process requests to change the grouper logic during this webinar. The next opportunity to petition 3M for changes will take place in the spring (MHA will put out a call for requests closer to the event). For those who cannot participate, a recording will be made available. Register for the webinar here .
Contact: Justin Ziombra
MPSC Event to Address Opioid Epidemic
The Maryland Patient Safety Center's (MPSC) Medication Safety Conference November 1 will address key medication management and safety issues for health care providers including physicians, patient safety officers, medication safety officers, pharmacists, nurses, and quality/risk professionals. The focus of this year's event, at the Hilton Baltimore, will be Maryland's opioid epidemic. AXIS Medical Education, the MPSC, and the Maryland Opioid Operational Command Center are partnering on the conference.  For more details or to register, click here .
AHA, Hospital Leaders Announce 340B Good Stewardship Principles
The American Hospital Association (AHA) and individual 340B hospitals announced new principles September 18 for ensuring good stewardship of the 340B program. This new AHA-led initiative will strengthen the 340B program by increasing transparency while helping 340B hospitals better communicate the value of the program for vulnerable patients and communities.
Good stewards of the program commit to communicate the value of the 340B program, share estimated savings from the program, and perform rigorous internal oversight. For more information and resources click here .
Mid-level Managers are CORE to the Change Effort
The role of the middle manager in our health care organizations is sometimes misunderstood in regard to the influence the individual manager has ensuring change happens well.

Prime's Value to Member Hospitals
Prime is the shared service/group purchasing subsidiary of the Maryland Hospital Association. Its goal is to help our member hospitals reduce the cost of care.

New Study Finds Hospital Outpatients, Including Cancer Patients, Are Sicker and Tend to Come From Lower-Income Communities Compared to Patients Treated in Independent Physician Offices
Medicare patients who receive care in a hospital outpatient department (HOPD) are more likely to be poorer and have more severe chronic conditions than Medicare patients treated in an independent physician office (IPO).

Tuesday, October 2
MHA Behavioral Health Task Force meeting
The Baltimore Sun , By Pamela Wood and Meredith Cohn, September 21
The Baltimore Sun , By Meredith Cohn, September 21
The Washington Post , By Jay Hancock, September 22
Baltimore Business Journal , By Morgan Eichensehr, September 24
Herald-Mail Media , By Julie E. Greene, September 25
The Baltimore Sun , By Erika Butler, September 27
The Baltimore Sun , By Jess Nocera, September 27
The Daily Record , By Tim Curtis, September 26